Potential Hepatitis A Exposure Linked To Frozen Strawberries


The Indiana State Department of Health (ISDH) and multiple local health departments are investigating potential exposure to hepatitis A virus (HAV) from contaminated frozen strawberries and food items made with them. These products are included in a nationwide recall and have been connected with a multistate outbreak investigation (http://www.cdc.gov/hepatitis/outbreaks/2016/hav-strawberries.htm). Although no reported cases of HAV infection associated with these products have been identified in Indiana, recalled strawberries have been distributed to multiple restaurants across the state. 

Hepatitis A vaccine and hepatitis A immunoglobulin can prevent infection if given within two weeks of exposure. This recall dates back to January 1, 2016, so most exposed individuals are beyond the two-week prophylaxis window for hepatitis A. However, eight restaurants in Hamilton, Hendricks, and Marion counties are currently known to have served these products within the past two weeks. Additional establishments may be identified as the investigation continues. 

Health care providers are encouraged to inquire about recent strawberry consumption in patients who present with symptoms of hepatitis A and order appropriate testing, particularly if they patronized restaurants in these counties. Health care providers should report suspect hepatitis A cases immediately to their local health department. 

Symptoms of hepatitis A appear 15-50 days (average of 30 days) after exposure and include nausea, vomiting, diarrhea, anorexia, abdominal pain, fever, and jaundice. Not everyone infected will exhibit all of these symptoms, and some people, especially children, may have no symptoms at all. Infection is spread through contaminated food, beverages, or person-to-person via the fecal-oral route. Treatment is supportive, and infection generally produces lifelong immunity. Individuals who are appropriately vaccinated are not at risk of infection. 

For questions, contact the Indiana State Department of Health, Epidemiology Resource Center at 317-233-7125